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Wednesday, Nov. 26, 2014

Over-prescribing charges dismissed

Wednesday, June 11, 2008

(Photo)
Denise Oldenberg, M.D. (right) discusses the medical board settlement with Dr. Kale, and attorneys Edward Chandler and Larry Kissee. Photo by Erma Harris
A local doctor has been placed on a two-year monitoring program after allegations of over-prescribing medications were dismissed against Denise Oldenberg, M.D. The action occurred at a hearing of the Arkansas State Medical Board (ASMB) June 6 in Little Rock.

"I really feel exonerated, and I feel the patients' rights have really been upheld and that this should bring about better communication between (law enforcement) and medical personnel," Oldenberg said.

"I'm pleased with the settlement," Oldenberg's attorney Edward Chandler said. "All the charges were dismissed. In my mind that means she's been cleared of all the things that that implied or involved, that she did not over-prescribe and that she is not responsible or liable for anybody's death, or we would not have reached this agreement."

Nov. 27, 2007, the medical board issued an order and notice of hearing charging Oldenberg. The order stated that Oldenberg "has prescribed scheduled medication for various individuals without proper diagnostic work-up or need for the medication before giving the prescriptions for the scheduled medication to individuals; all of this occurring in the spring of 2004, at a Dairy Queen in Salem, Ark."

In addition, three specific charges of over-prescribing were issued naming three of Oldenberg's patients, all deceased.

Oldenberg appeared before the medical board with her attorneys, Larry Kissee of Ash Flat, and Chandler of Mountain Home, who requested a monitoring plan be initiated instead of continuing with the disciplinary hearing.

Attorney for the medical board, William Trice, presented the offer to the board which was accepted. The plan is as follows:

Oldenberg will now be placed on a two-year program which will monitor all scheduled prescriptions written to her patients. She will be required to submit a monthly report to the medical board which will include the patient's name, date the prescription was written, the type and amount prescribed, the number of refills issued and the patient's diagnosis.

In addition, Oldenberg's patient files will have to be made available if requested to double-check the accuracy of her reports. A pharmacist investigator could also be used during this two-year period to contact area pharmacies to check that filled-prescriptions match her monthly report.

Oldenberg agreed to pay expenses incurred as a result of the investigation in the amount of $4,536, payable over a two-year period, as well as additional out-of-pocket expenses that may occur within the next six months, not to exceed $2,500.

According to reports, an investigation against Oldenberg began when Salem Police Chief Albert Roork expressed concern after investigations of multiple deaths in the area due to drug overdose or suicide. The report said that at each of these deaths, drugs, which were allegedly prescribed by Oldenberg, were found at the scene. Of the 8 deaths, only three of the individuals were present or past patients of Oldenberg.

"One of these people terminated their (patient) relationship with her (Oldenberg)," Kissee said. "Her last prescription was in September. She died in November and with the half-life of the prescription drugs, the drugs she had in her didn't come from Dr. Oldenberg. She got them from someone else. In another one, the guy got drunk. She had a signed contract with him that said he wouldn't drink. He went to a party, drank on top of the drugs and they claim that was the cause of death although my pathologist said it was from an enlarged liver."

"There's not a single shred (of evidence) that connects her to anyone's death," Chandler said.

According to Chandler, the death of one of the three patients named in the accusation, was investigated by federal authorities but no charges were ever filed.

"The FBI took all of her records in November of last year; they've had them all this time, no charges," Chandler said. "Marion County didn't accuse her of anything. Fulton County didn't accuse her of anything. Izard County didn't accuse her of anything. The National Parks Service didn't accuse her of anything. All of these agencies have investigated this -- the DEA, the FBI, the 16th Judicial Task Force. No one has made any kind of a charge at all. There's been no reason to. She's not connected with any of it."

According to reports, Oldenberg saw a patient for his first and only visit on May 31, 2007, where a prescription pain medication was prescribed. The patient died that same day as a result of a drug overdose at the Buffalo National River in Marion County.

After the vote to dismiss the allegations against her, Oldenberg said she is glad to put this behind her.

"I feel I have been exonerated," Oldenberg said. "This is a case that went well because of the work my attorneys and experts have done. I care about my patients and feel much more freer to treat correctly. I feel I've opened up the door for other physicians to treat pain adequately.

"I have talked with Albert Roork and I want to open up the door to communicate if we do have a problem patient. All my patients do have legitimate pain and the Legislature has opened the door for doctors to treat pain, but our medical board has been slow (in adopting guidelines or policy). We have a guide that says you cannot excessively prescribe. What Dr. Kale and Dr. Lipman (expert witnesses) have done is to define excessive, not based on numbers which has been done, but based on patient response. This is the ultimate ruler as to whether we over-prescribed or under-prescribed. This is our patient's ability to have quality of life again as opposed to what they were without their medication. That's the only standard that we really have and I feel freer to use that -- not feel freer to give more, but freer to look, 'is my patient's quality of life better, am I improving the situation,' and I have the assurance that the police is going to work with the doctors to make sure that we do have a safer environment. We can give Albert Roork credit for coming here and being concerned about the public because he gets a different angle of this from what I get.

"When I hear of a death, it hurts me too. That's not what I'm being a doctor for, I want to help people. I don't want people to harm themselves but what happens is that there is a term called sudo-addiction and that's when people are under-treated for pain. They want to be free of this pain so bad that they have some characteristics of an addict and they will do anything to get pain relief. In the past we've always said, 'that's an addict.' And pain patients have been so embarrassed to express, 'yes, I hurt, I can't do what I use to do,'" Oldenberg said.

According to a report, Oldenberg was also brought before the ASMB in March 1992, to answer allegations of "grossly negligent or ignorant malpractice, in the prescribing of excessive amounts of controlled substances to various patients and writing an excessive number of prescriptions for an addictive or potentially harmful drug." The ASMB's vote was overturned and reversed by Arkansas Court of Appeals in September 1993.

In November 1995, an investigative report says that Oldenberg appeared before the ASMB once again. At this hearing the ASMB voted to enter into an agreement and stipulated Oldenberg had violated the Medical Practices Act, specifically, the Arkansas Rules and Code of Federal Regulations concerning the inventory, accounting, distribution, dispensing and prescribing of controlled substances. Oldenberg's medical license was placed on probation for two years; she was ordered to refrain from practicing as a solo practitioner during this time; she was also required to take and complete 40 hours of continuing medical education each year of the two-year probation, a portion of which would be in the field of medical practice management.

Oldenberg's clinic, Rural Medical Clinic, is located at 266 Cardinal Drive in Horseshoe Bend.



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